340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOMETOWN DRUGS OF ROSEBURG INC
FQHC638492B Cow Creek Band of Umpqua Tribe of Indians
Print
Covered Entity Details
Entity Name
Cow Creek Band of Umpqua Tribe of Indians
Subdivision Name
Cow Creek Health & Wellness Center
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638492B
Entity Address
480 Wartahoo Lane
Canyonville, OR 97417
Grant Number
Participating Start Date
4/1/2013
Last Recertification Date
2/26/2018
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
HOMETOWN DRUGS OF ROSEBURG INC
Pharmacy Address
1813 W HARVARD STREET
SUITE 210
ROSEBURG, OR 97471
Pharmacy Comments
Contract Details
Approval Date
7/1/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sharon Arlene Stanphill, Health Operations Officer
(541) 672-8533 Ext: 5517
Contract Pharmacy Representative
Hometown Drugs of Roseburg
Robert Doug, Owner/Pharmacist
(541) 229-1112
Signed By Date
7/1/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session